Following is an update on proposed 2011 Oregon state legislation with the potential to influence perinatal outcomes.
Oregon House Bill 2380
Recently amended, HB 2380 creates a majority of licensed direct-entry midwives on the Oregon Board of Direct Entry Midwives. This is accomplished by reducing the total number of board members from eight to seven. The bill also establishes protected peer review for licensed direct entry midwives. Additionally, the bill requires the Board to collect and report birth data. Outcomes between licensed and unlicensed direct entry midwives will be distinguished in Board reporting.
Before amendment, HB 2380 would have required Oregon’s direct-entry midwives to become state licensed providers. This would have replaced the current voluntary licensure system. MotherBaby Network blogged about this proposed requirement shortly after the bill was introduced in February. The Lund Report just reported on amending of this bill.
The Oregon Midwifery Council supports HB 2380 and encourages its supporters to contact their state representative in the House to encourage a “yes” vote.
Oregon House Bill 3311
HB 3311 has been amended to require that the “Oregon Health Authority, including the Office of Multicultural Health and Services, shall explore options for providing or utilizing doulas and other community health workers in the state medical assistance program to improve birth outcomes for women who face a disproportionately greater risk of poor birth outcomes.” If passed, OHA would report outcomes to the Health Care Committee in February 2012.
The original bill language focused on improving outcomes for women of color. The amended language is improved by expanding 3311’s focus to include all women who are at a disproportionate risk for poor outcomes. This bill is of particular interest for Lane County, where MotherBaby Network originates, given its disturbingly high rate of fetal-infant mortality. Our overall rate is higher than the nation; higher than the state; and higher than comparable counties and metropolitan areas.
HB 3311 has the potential to address gaps in maternity services by better-integrating doulas and community health workers into the model of care. Doulas are labor companions who provide the emotional and non-medical support all to frequently absent from a laboring woman’s side. Doulas are a well documented evidence based and non-medical intervention with a proven track record for positively influencing the social, physical and emotional outcomes of the perinatal period.
HB 3311 follows Amnesty International’s 2010 release of Deadly Delivery: The Maternal Health Care Crisis in the USA. Amnesty International reports that despite spending more than any other country on earth on maternal health, US women are at greater risk of dying of pregnancy-related complications than their counterparts in 49 other countries including Kuwait and Bulgaria. Among US women, African-American women are nearly four times as likely to die of pregnancy complications than white American women.
HB 3311 enjoys support from bill sponsor Rep. Tina Kotek as well as from the following organizations:
Coalition of Local Health Officials
International Center for Traditional Childbearing
The Urban League of Portland